Internal Bleeding: The Truth Behind America's Terrifying Epidemic of Medical Mistakes - Essential Reading for Healthcare Professionals & Patient Advocates

I strongly suspect that the publishers insisted on the title of this book over the objections of the authors, because (as another reviewer has noted) the title is clearly sensationalistic and very much out of line with the even-handed and level-headed treatment of the rest of the book. Indeed, the title is perhaps the ONLY thing I would criticize about this otherwise excellent and gripping description of the underlying causes of medical mistakes and what can be done about them.I cannot praise the quality of the writing enough. The authors accomplish just the right blend of fascinating case studies and theoretical analysis. They make their basic point (that any system run by humans is fallible and medical mistakes are inevitable) very effectively in the beginning pages of the book by describing two case studies where mistakes were made...with the punch line being that the mistakes were committed by the authors themselves. Beginning the book this way was in part so effective because it gets across the message that the vast majority of mistakes that are made are not the result of negligent, careless, or malicious physicians; rather, they are the inevitable consequence of a system that struggles to cope with the complexity of the ever-changing demands of a never-ending stream of patients.The second most admirable feature of this book, in my opinion, is that it does not merely criticize but also offers suggestions for improving the delivery of medical services to eliminate errors, from such simple steps as physicians "signing their sites" (to prevent, say, amputation of the wrong limb) to computerizing medication orders (to prevent errors due to physicans' notoriously poor handwriting) to more systemic changes in malpractice law. I thought the authors' suggestions on this latter topic to be highly intriguing and novel. The idea of adopting a modified no-fault system for compensating patients injured by medical errors is, in my mind, a terrific idea, and I would love to see the authors' recommendations in this regard enter the national debate on malpractice litigation reform.Perhaps the only part of the book I found even slightly disappointing was the authors' reluctance to deal more bluntly with the problem of incompetent or alcoholic/drug dependent doctors. The authors acknowledge that these "bad apples" exist, but they do little beyond saying that hospitals and physicians tend to cover up for the incompetents in their ranks. My mother-in-law died from botched surgery; after she died, the hospital risk manager told us to our faces that this particular surgeon had had "other surgeries that did not turn out as he had planned." I think if I had read this book before my mother-in-law died, I would have been more proactive in pressing our complaints about this surgeon, who--a scary thought--is still operating on people but probably should not be.But these kinds of physicians are in the minority, and the contribution this book makes is to describe the much more common ways in which patients end up being hurt by medical care designed to help them.I read a lot of nonfiction, and this book is one of the rare examples of nonfiction that can keep you glued to your chair and turning the pages eagerly. I think it ranks right up there with Jon Krakauer's "Into thin air" and Richard Preston's "The hot zone" in terms of readability and interest value. Yet it also probably outranks those and other books in terms of potential social value. It could well be one of the few books with potential to inform and enable real changes in social policy that has been published lately.